Focus of the Report: The use of radiofrequency ablation (RFA) of the genicular nerves for the treatment of osteoarthritis of the knee (KOA).

Technology Description: In this report, RFA is defined as ablation of the peripheral nerves of the knee to relieve the pain associated with KOA. The genicular nerves supply the knee and include the articular branches of the obturator, femoral, saphenous, common peroneal, and tibial nerves. During RFA, radiofrequency energy delivers heat to the target nerve, thereby creating a lesion that stops pain input to the central nervous system.

Controversy: Uncertainty remains for the use of RFA due to the lack of standardization in procedural techniques, and there are currently no established treatment guidelines that recommend the use of RFA for KOA (Ajrawat et al., 2020). Additionally, the effects of RFA in general are temporary and generally limited to 1 year, as pain signal transmission will return with peripheral nerve regrowth and regeneration (Kidd et al., 2019).

Key Questions:

  • Is RFA of the genicular nerves effective in treating the pain associated with KOA?

  • How does RFA of the genicular nerves compare with clinical alternatives for pain associated with KOA?

  • Is treatment with RFA of the genicular nerves safe?

  • Have definitive patient selection criteria been identified for RFA of the genicular nerves?

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